Jillian Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12308 Issued in CT

Practice address

16 Hawthorne CT
Higganum, CT 06441-4281

Phone

(860) 335-6145

NPI assigned

Jan 13, 2020

Last updated

May 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Resources, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windsor, CT
  • NPI 1215979810

  Mental Health (Including Community Mental Health Center)

  Medicare reassignment NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Hospitalist Physician
  • New Britain, CT
  • NPI 1063461481
  Medicare reassignment NPD
• Calming Connection LLC

  • Social Worker
  • Higganum, CT
  • NPI 1790534535
  NPD Authorized official
• Community Health Resources, Inc.

  • Primary Care Clinic/Center
  • Enfield, CT
  • NPI 1346700093
  NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Psychiatric Hospital Unit
  • New Britain, CT
  • NPI 1992867006
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1023658564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HAWTHORNE CT",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414281",
            "telephone_number": "860-335-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HAWTHORNE CT",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414281",
            "telephone_number": "860-335-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JILLIAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polish Caregivers LLC
• Ptsma, Inc. (Select Physical Therapy)
• Regional School District 17
• Stephanie Ann Reilly, PMHNP
• Ryan L Roth, APRN
• Linda H Schroth, M.D.
• Angie Seech, PHD, LPC, NCC
• Erin Sember
• Ronald Soper, RPH
• Danielle M. Tabaka, P.A.

• Clinical Social Worker in Higganum, CT
• Providers in Higganum, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.